Lisa Marie Jackson

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

33455 6TH Ave S # 2C
Federal Way, WA 98003-6074

Phone

(253) 210-4230

NPI assigned

Jul 25, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lightheart Associates PSGroup PAC ID 2163889981, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lightheart Associates PS

  • Psychologist
  • Redmond, WA
  • NPI 1609221720

  Professional

  Medicare reassignment Care Compare group NPD
• Dr. Kathleen Worsley

  • Counseling Psychologist
  • Redmond, WA
  • NPI 1619484821
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1690243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1497436349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11723 SE 157TH ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980584636",
            "telephone_number": "253-229-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33455 6TH AVE S # 2C",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036074",
            "telephone_number": "253-210-4230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-25",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MHCA.MC.61464859",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mona Jaber
• Thomas E. Jacka, D.D.S.
• Nina Jackson-King
• Kyrsten Savannah Jackson-Kinney
• Duane L Jackson Jr., O.D.
• Mara Jacobo Amezquita, DPT
• Ruth Jacobs
• Yonaton A Jacobs, ARNP
• Bret H Jacobson, DDS
• Carl Jacobson, DDS

• Professional Counselor in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Professional Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.